| NPI | 1013503762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL 11006625) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: CA 95015461) |
| Enumeration Date | 2020-12-16 |
| Last Update Date | 2020-12-16 |